application of systems thinking in health: opportunities for translating theory into practice; comment on “constraints to applying systems thinking concepts in health systems: a regional perspective from surveying stakeholders in eastern mediterranean countries”

systems thinking is not a new concept to health system strengthening; however, one question remains unanswered: how policy-makers, system designers and consultants with a system thinking philosophy should act (have acted) as potential change agents in actually gaining opportunities to introduce systems thinking? development of comprehensive multi-year plans (cmyps) for immunization system is one such opportunity because almost all low- and middle-income countries (lmics) develop and implement cmyps every five years. without building upon examples and showing practical application, the discussions and deliberations on systems thinking may fade away with passage of time. there are opportunities that exist around us in our existing health systems that we can benefit from starting with an incremental approach and generating evidence for longer lasting system-wide changes.